Questions_and_Answers.docx

SCH50017R2000

LES Health/Life Insurance Questions and Answers

For any answer provided regarding claims data incurred under the existing contract, please be advised this data may not be indicative of future claims. Therefore, it is each offeror’s decision on whether to use or not to use this information. However, under no circumstances shall the U.S. Government (USG) be liable for this data or shall it become the basis for a request to adjust the premium rates once the contract is awarded. Rather, offerors are advised any adjustments to contract premium rates shall be in accordance with the Price Adjustment clauses B.4. and B.8 Also, any historical data incurred under the current contract is providing for informational purposes only as it may not be indicative of future data.

1. Q: Please provide individual information of:

A:

Age/DOB of Employees See solicitation section J

Gender of Employees See solicitation section J

Dependent status i.e., Coverage for Employee (E); Employee & Spouse (E/S); Employee & Children (E/C); Employee, Spouse & Children (E/S/C) See solicitation section J

2. Q: Please provide information of claims history: 2014, 2015, 2016, and YTD 2017.

A: See Question 5

3. Q: Please provide information of catastrophic cases.

A: See Question 17 and 22.

4. Q: Please provide nationality of the insureds.

A: Most of the insured individuals are Chinese. About 15 people have foreign nationality.

5. Q: Please provide claims history for health insurance for the current year and EACH of the last 5 years - 2017 (till now), 2016, 2015, 2014, 2013, and 2012.

A:

6. Q: Do the above claim numbers include claims from ORE employees?

A: No – since they are riders under the contract.

7. Q: Please provide claims history for life insurance for the current year and EACH of the last 5 years - 2017 (till now), 2016, 2015, 2014, 2013, and 2012.

A:

8. Q: Do the above claim numbers include claims from ORE employees?

A: No– since they are riders under the contract.

9. Q: Please provide premium history for health Insurance for the current year and EACH of the last 5 years - 2017 (till now), 2016, 2015, 2014, 2013, 2012.

A: The record of total premium for both health and life insurance is RMB 6,350,084 (2013), RMB 7,237,431 (2014), RMB 7,758,424 (2015), RMB 8,489,111 (2016), RMB 9,071,829 (2017)

10. Q: Did the Premium history for health insurance above include the VAT? If it did then what % VAT was included in the historical health premiums?

A: VAT was not included in the premium history.

11. Q: Please provide premium history for life Insurance for the current year and EACH of the last 5 years - 2017 (till now), 2016, 2015, 2014, 2013, 2012.

A: See question 9 for answer

12. Q: Did the Premium history for life insurance above include the VAT? If it did then what % VAT was included in the historical health premiums?

A: VAT was not included in the premium history.

13. Q: Average insured member counts for the current year and EACH of the last 5 years - 2017 (till now), 2016, 2015, 2014, 2013, 2012.

A: See Section J. The number of employees and dependents who are enrolled increase every year. The increase is 5% increase each year.

14. Q: Please advise if 2016 benefit schedule for health insurance is the same as the benefit schedule currently being requested under SCH50017R2000; and if not advise us on the differences. Alternatively, you can simply provide the previous solicitation document.

A: The only difference is that the annual physical exam is capped at RMB 650 per person per year.

15. Q: Advise if 2016 benefit schedule for life insurance is the same as the benefit schedule currently being requested under SCH50017R2000; and if not advise us on the differences. Alternatively, you can simply provide the previous solicitation document.

A: It is the same

16. Q: Are there any persons who are currently hospitalized? If yes, please provide number A: 58 people

17. Q: Are any major illnesses (Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases) being treated? If yes, please provide number A: 4 cases in 2015, 5 cases in 2016, and 7 cases in 2017

18. Q: Are there any pregnant employees/spouses? If yes, please provide number A: Estimated ten employees in total at six locations.

19. Q: Are there any large losses (in excess of $10,000) within the last year to date? If yes, please provide number.

A: No

20. Q: Are there any HIV/AIDs cases? If yes, please provide number.

A: No

21. Q: Please advise whether any of the persons covered are required to carry firearms and if so, please indicate them appropriately in Exhibit A or in the census.

A: No

22. Q: Are any persons not actively at work? If yes, please let us know the total number.

A: Three employees are not actively at work

23. Q: Are there any disabled lives? If yes, indicate in Exhibit A or just let us know the total number.

A: No

24. Q: When is this plan likely to commence?

A: The period of performance for the contract will be set forth in the Notice to Proceed letter, which can only be issued after contract award. Contract award is anticipated in the first quarter of calendar year 2018.

25. Q: Please provide number of annual insureds or increase in past few years.

A: See Section J. The number of employees and dependents who are enrolled increase every year. The increase is 5% increase each year.

26. Q: Please provide claim data over past three years, such as claim cases, claim categories and claim sum.

A: See Question 5, 6 and 7.

27. Q: The salary (monthly or weekly or bi-weekly) of the highest paid staff, employee and ORE.

A: The highest salary for employee is RMB 673,093 per year (or RMB 25,888 by-weekly). This amount is already included in the average salary rate in the solicitation. The highest salary for ORE is RMB 156,000 per year (or RMB 6,000 by-weekly). This amount is already included in the average salary rate in the solicitation.

28. Q: Personnel category in each city, including number of staff, spouses and children.

A: See Section J

29. Q: Does Term Life include total disability caused by diseases?

A: Not covered

30. Section B PART I PRICE-HEALTH INSURANCE, PART II PRICE-GROUP LIFE INSURANCE

(1) Q: Page 3-5 & Page 8-10, require the premium of base year and option years, whether the rates of option years shall be actual premium or just for consideration ？ A: Section B.2.3 to B.2.8 and B.6.1 to B.6.6 shall be filled with each offeror’s firm fixed price premium rate. Any adjustment in the premiums shall be in accordance with the EPA clauses set forth in B.4 and B.8.

(2) Q: Page 5 & Page 10, B.3/B.7 “This retention amount will not be adjusted for any reason.” Considering company may change the service vendor in the future, if services changed or upgraded causing the retention change, is it acceptable to make proper adjustment?

A: There shall be no adjustment to the retention amounts in B.3 and B.7.

31. In Section C PART I HEALTH INSURANCE

(1) Q: Please identify coverage area: 1) China mainland; 2) Greater China; 3) Global exclusive US & Canada; 4) Global？ A: China mainland

(2) Q: Does hospital range include expensive hospitals？ A: Hospitals covered under this plan are social insurance (shebao)-covered hospitals. Shebao medical covers the basic medical coverage for an employee. The reimbursement rate by Shebao is ranged from 70% to 90% depending on the level of hospitals.

(3) Q: In Section H 4 (b) - (4) Whether need direct-billing for both in-patient and out-patient? For Medical Insurance Claims settlement, whether account transfer to employees‘ personal accounted is accepted instead of checks?

A: Employees will pay expenses first and then submit receipts for reimbursement.

(4) Q: P14 C.1.2.5, “For employees regularly scheduled to work 30 hours or more per week, the maximum annual reimbursement for both the employees and his or her dependent is RMB 80,000 per year per person.” How about the separated yearly limitation for out-patient, in-patient and maternity or we can propose properly? Is this maximum amount applied to those employees working less than 30 hours per week and ORE staff?

A: they receive the same benefits as the full time employees receive.

32. Section J LIST OF EXHIBITS/ATTACHMENTS

1) Q: Please provide total insured numbers in recent three years or increase ratio.

A: See Section J. The number of employees and dependents who are enrolled increase every year. The increase is 5% increase each year.

2) Q: Please provide the highest bi-weekly salary amount of employee and ORE staff.

A: See Question 27.

(3) Q: Please provide personnel distribution of employees, dependents and children separately in all located cities.

A: See Section J

(4) Q: Please provide the gender proportion of employees and ORE employees.

A: See Section J.

33. Q: P15, C1.5 “There is no age limit for a child who is physically or mentally handicapped so as to be unable to live independently.” Please provide detailed data including personnel amount, description/diagnosis of physically or mentally handicapped, past insured conditions etc. for general evaluation.

A: This type of information will not be released. However, any dependent which falls into this category will be listed as a dependent within Section B

34. Q: Personnel category in each city: employee, spouse, children. How many spouses and children?

A: See Section J

35. Q: What is the reimbursement rate for the last three years? Please specify the rate for medical, life and accidental death.

A: See Question 5, 6 and 7.

36. Q: Prescribed eyeglasses or contact lenses with a 60 USD ceiling for two lenses per patient per year. Dental care, contractor paid 50% with a ceiling of 1000USD per year. Can it be underwritten in RMB?

A: The ceilings of 60 USD and 1000 USD will remain in USD

37. Q: C3.0 There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently. What is the meaning of this sentence?

A: If the child has the above mentioned condition, the child is not limited to age 18 or age 24.

38. Q: Is there any need to have separate bill for B5.1?

A: No need to provide separate invoice.

40. Q: We would like to know if you have been informed of Catastrophic cases presented last year, such as: Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases (Radio and Chemotherapy), and hospitalizations with more than 10 days.

A: See Question 17 and 22.

41. Q: Does this solicitation number SCH50017R200 contain requirements similar to the current contract? If no what are the differences?

A: See Question 14.

42. Q: Have there been any claims in excess of $10,000 within the last year? If yes please indicate the number and amounts of such claims.

A: No

43. Q: Are there dependent children to be covered who are studying outside the country? If yes please provide the country and number of dependent children studying there.

A: The health and life insurance is supplement to the local social insurance, so the expenses occurred outside of mainland China will not be covered.

44. Q: Please confirm prospective offers must submit proposals for both Life and Health insurance opposed to being allowed to submit proposals on both or just one of the types of coverage?

A: Must submit proposals for both life and health insurance – see L.4.2. and M.7

45. Q: There are three parts medicine of A, B and C in the reimbursement scope of China basic medical insurance. A is fully covered by social security, B is paid partly by the individual, C is completely paid by the individual. What is the coverage of supplementary health insurance to be provided to US Embassy Beijing?

A: As this plan is Shebao supplementary plan, it only covers the medicines that Shebao covers.

46. Q: Does the coverage of supplementary health insurance you need include the service of VIP department and international department in public hospital?

A: As this plan is Shebao supplementary plan, if Shebao does not cover the service of VIP department and international department in public hospital, then it is not covered by this plan.

47. Q: Is this a voluntary insurance or compulsory insurance, what is the rate of insurance covering?

A: It is voluntary. However, it is about 95% of employees are enrolled in this plan.

48. Q: What was the loss ratio of US Embassy Beijing in the past 5 years, will the insurance plan be as same as before?

A: See Questions 5, 6, 9 and 11.

49. Q: Could you please advise the highest age for employee and spouse?

A: It is age 74 for employee and age 68 for spouse. This data is already calculated in the average age.

50. Q: In the past 5 years, could you please advise whether there is a change for coverage? If yes, which year and what changes?

A: See Question 14.

51. Q: Could you please advise the number of members for the insured in the past 5 years? (Including employee and dependent) A: See Section J. The number of employees and dependents who are enrolled increase every year. The increase is 5% increase each year.

52. Q: Could you please advise the claim amount for the past 5 years? (Including Medical Insurance and Life Insurance) A: See Question 5 and 7.

53. Q: Are there any members that already have critical diseases? How many? And what’s the diagnosis? (Including employee and dependent) A: See Question 17 and 22.

54. Q: What is the VAT mentioned in the solicitation document?

A: VAT mentioned in the solicitation refers to Chinese Value-added Tax. It only applies to Chinese companies, and the rate varies according to company’s scale and business category. The Chinese companies are required to provide the VAT rate as part of the price quote.